ABSTRACT Introduction. The World Health Organization (WHO) recommends conducting nationally representative studies to estimate the prevalence of HIV pretreatment resistance to antiretrovirals (PDRs) to assess the effectiveness of first-line therapies. The objective of the present study was to determine the prevalence of PDR in Cuban adults infected with HIV-1. Methods. HIV resistance to antiretrovirals was determined in 610 Cuban patients in two time periods (469 patients between 2009-2016 and 141 patients during the national survey of HIV-1 PDR conducted during 2017, according to the recommendations issued by the WHO). Results and Discussion. In the period 2009-2016, 19% of the patients presented viruses with some mutation associated with the PDR of HIV-1 to antiretrovirals (10,4 % to some nucleoside reverse transcriptase inhibitor (NRTI), 12,8 % to some non nucleoside reverse transcriptase inhibitor (NNRTI), 2,8 % to some protease inhibitor (PI). In 2017, the prevalence of PDR was 29,8 % (95 %, CI 22,3-38.1). The prevalence was 10,6 % (95 %, IC 6,07-16,9) for some NRTI, 23,4 % (95 %, CI 16,7-31,3) for some NNRTI, and 1,4 % (95 %, CI 0,17-5,03) for some PI. It was concluded that the NNRTI prevalence above 10 % in our study indicates that the first-line antiretroviral therapy in Cuba may be less effective and supports the need to look for new treatment options.

RESUMEN Introducción. La Organización Mundial de la Salud (OMS) recomienda la realización de estudios representativos a nivel nacional para estimar la prevalencia de la resistencia pretratamiento del VIH a los antirretrovirales (PDR) para evaluar la efectividad de las terapias de primera línea. El objetivo del presente estudio fue determinar la prevalencia de PDR en adultos cubanos infectados por el VIH-1. Métodos. Se determinó la resistencia del VIH a los antirretrovirales a 610 pacientes cubanos en dos períodos de tiempo (469 pacientes entre 2009-2016 y 141 pacientes durante la encuesta nacional de PDR del VIH-1 efectuada durante el año 2017, según las recomendaciones emitidas por la OMS). Resultados y Discusión. En el período 2009-2016, el 19 % de los pacientes presentaron virus con alguna mutación asociada a la PDR del VIH-1 a los antirretrovirales (10,4 % a algún inhibidor de la transcriptasa inversa análogo de nucleósidos (ITIAN), 12,8 % a algún inhibidor de la transcriptasa inversa no análogo de nucleósidos (ITINAN), 2,8 % a algún inhibidor de proteasa (IP). En el año 2017, la prevalencia de PDR fue de 29,8 % (95 %, IC 22,3-38,1). La prevalencia fue de 10,6 % (95 %, IC 6,07-16,9) para algún ITIAN, 23,4 % (95 %, IC 16,7-31,3) para algún ITINAN y 1,4 % (95 %, IC 0,17-5,03) para algún IP. Se concluyó que los valores por encima del 10 % en la prevalencia de la PDR a los ITINAN evidencia el comprometimiento de la primera línea de terapia antirretroviral empleada en Cuba y la necesidad de buscar nuevas opciones de tratamiento.

ABSTRACT Introduction: Open tibial fractures are a subset of the trauma burden in Latin America. Questions related to treatment, potentially critical in Cuba, a country with limited resources, but with standardized national health program, coherence in education, and similarities of graduate programs were examined. Objective: To describe the treatment patterns of open tibial fracture in Cuba, and to compare the characteristics of acute and late management in seven provinces of the country. Methods: Sixty seven orthopedic surgeons were surveyed to evaluate four aspects of open fracture management, regarding antibiotic prophylaxis, irrigation and debridement, stabilization, and wound management. The convenience sampling method was used to identify surgeons and the analysis was performed using Fisher's exact test (p <0.05). Results: Postoperative antibiotics were administered for more than 72 hours for GA-I / II fractures (49%) and GA-III fractures (70%). Surgeons in Havana (n = 32) used primary internal fixation for GA-I / II fractures more frequently than surgeons in the remaining provinces (n = 35) (64.3% vs. 30.3%, p = 0.008). Surgeons from other provinces performed primary closure at the time of definitive fixation of GA-I / II fractures more frequently than those from Havana (62.9% vs. 32.3%, p = 0.013). For GA-III fractures, the majority of Havana surgeons (88.6%), as well as those of the remaining provinces (96.8%) preferred to perform deferred closure. Conclusions: The treatment of open tibial fractures in Cuba is generally consistent with other Latin American countries. The characteristics of the management of open tibial fractures in Cuba are described and differences in wound stabilization and treatment methods between provinces are compared, which is useful to assess whether they are the result of differences in surgical practice, or in availability of resources. This is helpful in addressing ways to optimize patient care through specialized training and resource allocation.

RESUMEN Introducción: Las fracturas abiertas de tibia son un subconjunto de la carga de traumatismos en América Latina. Se examinaron cuestiones relacionadas con el tratamiento potencialmente críticas en Cuba, país con recursos limitados, pero con un programa nacional de salud estandarizado, coherencia en educación y similitudes de programas de posgrado. Objetivos: Describir los patrones de tratamiento de la fractura abierta de tibia en Cuba, y comparar las características del manejo agudo y tardío en siete provincias del país. Métodos: Se encuestaron 67 cirujanos ortopédicos para evaluar cuatro aspectos en el tratamiento de la fractura abierta: profilaxis antibiótica, irrigación y desbridamiento, estabilización y tratamiento de heridas. Se utilizó el método de muestreo por conveniencia para identificar a los cirujanos y el análisis se realizó mediante la prueba exacta de Fisher (p < 0,05). Resultados: Se administraron antibióticos posoperatorios durante más de 72 horas para las fracturas GA-I/II (49 %) y las fracturas GA-III (70 %). Los cirujanos de La Habana (n= 32) utilizaron con más frecuencia la fijación interna primaria para las fracturas GA-I/II, que los cirujanos en las restantes provincias (n= 35) (64,3 % vs. 30,3 %, p= 0,008). Los cirujanos de otras provincias realizaron cierre primario en el momento de la fijación definitiva de fracturas GA-I /II con más frecuencia que los de La Habana (62,9 % vs. 32,3 %, p= 0,013). Para fracturas GA-III, la mayoría de los cirujanos habaneros (88,6 %), al igual que los de las restantes provincias (96,8 %) prefirieron realizar cierre diferido. Conclusiones: El tratamiento de fracturas abiertas de tibia en Cuba es generalmente consistente con otros países de América Latina. Se describen las características del manejo de fracturas abiertas de tibia en Cuba y se comparan las diferencias en los métodos de estabilización y tratamiento de heridas entre provincias, lo cual resulta útil para evaluar si son resultado de diferencias en la práctica quirúrgica, o en la disponibilidad de recursos. Esto representa una ayuda al abordar las formas de optimizar la atención al paciente, a través de la capacitación especializada y la asignación de los recursos.

RESUMO Introdução: a hipertensão arterial (hipertensão) é um dos grandes desafios da medicina moderna, devido à sua alta prevalência, é provavelmente o problema de saúde mais importante nos países desenvolvidos e subdesenvolvidos. Afeta cerca de um bilhão de adultos e, segundo as projeções até 2025, haverá 1,5 milhão de pessoas com a doença, o que equivale a 30% da população mundial. Objetivo: identificar a presença de distúrbios depressivos e eventos vitais em pacientes com hipertensão arterial e sua relação com a adesão à terapia anti-hipertensiva. Método: estudo descritivo, transversal, com 222 pacientes hipertensos do Hospital Central de Nampula, Moçambique. Foram estudadas algumas variáveis sociodemográficas, sintomatologia depressiva, diagnóstico psiquiátrico, eventos vitais atuais e adesão terapêutica. Análises bivariadas foram realizadas para correlacionar a adesão ao tratamento com a presença de sintomas psicológicos, tratamento psicofarmacológico, eventos vitais e diagnóstico de doença depressiva. Resultados: a frequência de sintomas depressivos foi de 40,5%. Os diagnósticos mais frequentes foram transtorno depressivo maior, distúrbio distímico e distúrbios adaptativos com humor depressivo. Os eventos vitais atuais afetaram 77,9% dos pacientes hipertensos; os mais frequentes foram a morte de parentes queridos, sofrendo de doenças físicas e conflitos interpessoais. 42,8% apresentaram baixa adesão à medicação anti-hipertensiva, que foi significativamente associada (p <0,05) à presença de sintomas depressivos, necessidade de tratamento psicofarmacológico, sendo afetada por três ou mais eventos atuais da vida e tendo Diagnóstico de um distúrbio depressivo. Conclusões: a frequência de depressão é alta em pacientes hipertensos e os deprimidos apresentam baixa adesão terapêutica. Os eventos vitais atuais influenciam negativamente a adesão ao tratamento anti-hipertensivo.

ABSTRACT Introduction: arterial hypertension (hypertension) is one of the great challenges of modern medicine, due to its high prevalence, it is probably the most important health problem in developed and underdeveloped countries. It affects about one billion adults and according to projections by 2025 there will be 1.5 million people with the disease, which is equivalent to 30% of the world's population. Objective: to identify the presence of depressive disorders and vital events in patients with arterial hypertension and their relationship with adherence to antihypertensive therapy. Method: a descriptive, cross-sectional study was conducted with 222 hypertensive patients from the Central Hospital of Nampula, Mozambique. Some sociodemographic variables, depressive symptomatology, psychiatric diagnosis, current vital events and therapeutic adherence were studied. Bivariate analyzes were performed to correlate adherence to treatment with the presence of psychological symptoms, psychopharmacological treatment, vital events and diagnosis of depressive illness. Results: the frequency of depressive symptoms was 40.5%. The most frequent diagnoses were major depressive disorder, dysthymic disorder and adaptive disorders with depressive mood. Current vital events affected 77.9% of hypertensive patients; the most frequent were the death of loved relatives, suffering from physical illnesses and interpersonal conflicts. 42.8% had poor adherence to antihypertensive medication, which was significantly associated (p <0.05) with the presence of depressive symptoms, need for psychopharmacological treatment, being affected by 3 or more current life events and having Diagnosis of a depressive disorder. Conclusions: the frequency of depression is high in hypertensive patients and depressed patients have poor therapeutic adherence. Current vital events negatively influence compliance with antihypertensive treatment.

RESUMEN Introducción: la hipertensión arterial (HTA) es uno de los grandes desafíos de la medicina moderna, por su elevada prevalencia, constituye probablemente, el problema de salud más importante en los países desarrollados y subdesarrollados. Afecta a alrededor de mil millones de personas adultas y según proyecciones para el 2025 habrá 1,5 millones de personas con la enfermedad, que equivale a 30 % de la población mundial. Objetivo: identificar la presencia de trastornos depresivos y eventos vitales en pacientes con hipertensión arterial y su relación con la adherencia a la terapia antihipertensiva. Método: se realizó un estudio descriptivo, transversal con 222 pacientes hipertensos del Hospital Central de Nampula, Mozambique. Se estudiaron algunas variables sociodemográficas, sintomatología depresiva, diagnóstico psiquiátrico, eventos vitales actuales y adherencia terapéutica. Se hicieron análisis bivariados para correlacionar la adhesión al tratamiento con la presencia de síntomas psicológicos, tratamiento psicofarmacológico, eventos vitales y diagnóstico de enfermedad depresiva. Resultados: la frecuencia de síntomas depresivos fue de 40,5 %. Los diagnósticos más frecuentes fueron trastorno depresivo mayor, trastorno distímico y trastornos adaptativos con estado de ánimo depresivo. Los eventos vitales actuales afectaron a 77,9 % de los hipertensos; los más frecuentes fueron la muerte de familiares queridos, padecer enfermedades físicas y los conflictos interpersonales. El 42,8 % tenía una pobre adherencia a la medicación antihipertensiva, la que se asoció significativamente (p<0,05) con la presencia de síntomas depresivos, necesidad de un tratamiento psicofarmacológico, ser afectado por 3 o más eventos vitales actuales y tener diagnóstico de un trastorno depresivo. Conclusiones: la frecuencia de depresión es elevada en hipertensos y los pacientes deprimidos tienen una pobre adherencia terapéutica. Los eventos vitales actuales influyen negativamente en el cumplimiento del tratamiento antihipertensivo.

ABSTRACT INTRODUCTION Cuba’s HIV epidemic is characterized by high genetic diversity, with circulation of several subtypes and recombinant forms. Earlier studies described a predominance of subtype B in the HIV-positive population, but these studies did not take into account patients’ epidemiologic history. OBJECTIVE Clarify the origin and phylodynamics of HIV-1 subtype B in the Cuban epidemic. METHODS We analysed phylogenetic relationships among 120 sequences (from different geographic origins) of the pol gene in HIV-1 subtype B isolates from Cuban patients diagnosed from 1987 through 2012. Time of HIV-1 subtype B introduction and viral evolutionary rate were determined using a Bayesian coalescent method. RESULTS Based on phylogenetic relationships, subtype B was introduced into Cuba multiple times. Subtype B spread in Cuba through dissemination of strains that probably came from the USA, Canada and Europe. The time of the most recent common ancestor of Cuban subtype B was close to 1977 (95% CI 1974–1982), and the evolutionary rate was 2.7 × 10-3 nucleotide substitutions per site per year. CONCLUSIONS Our results suggest multiple introductions of HIV-1B into Cuba in the late 1970s, predominantly strains from North America and Europe. The results reflect the importance of maintaining, reviewing and updating molecular epidemiology of HIV-1 in Cuba, due to its rapid evolution and possible implications for the National STI/HIV/AIDS Program of Cuba’s Ministry of Public Health.

INTRODUCTION Serological and molecular HIV-1 studies in Cuba have shown very low prevalence of seropositivity, but an increasing genetic diversity attributable to introduction of many HIV-1 variants from different areas, exchange of such variants among HIV-positive people with several coinciding routes of infection and other epidemiologic risk factors in the seropositive population. The high HIV-1 genetic variability observed in Cuba has possible implications for transmission and clinical progression. OBJECTIVES Study genetic variability for the HIV-1 env, gag and pol structural genes in Cuba; determine the prevalence of B and non-B subtypes according to epidemiologic and behavioral variables and determine whether a relationship exists between genetic variability and transmissibility, and between genetic variability and clinical disease progression in people living with HIV/AIDS. METHODS Using two molecular assays (heteroduplex mobility assay and nucleic acid sequencing), structural genes were characterized in 590 people with HIV-1 (480 men and 110 women), accounting for 3.4% of seropositive individuals in Cuba as of December 31, 2013. Nonrandom sampling, proportional to HIV prevalence by province, was conducted. Relationships between molecular results and viral factors, host characteristics, and patients’ clinical, epidemiologic and behavioral variables were studied for molecular epidemiology, transmission, and progression analyses. RESULTS Molecular analysis of the three HIV-1 structural genes classified 297 samples as subtype B (50.3%), 269 as non-B subtypes (45.6%) and 24 were not typeable. Subtype B prevailed overall and in men, mainly in those who have sex with men. Non-B subtypes were prevalent in women and heterosexual men, showing multiple circulating variants and recombinant forms. Sexual transmission was the predominant form of infection for all. B and non-B subtypes were encountered throughout Cuba. No association was found between subtypes and transmission or clinical progression, although the proportion of deaths was higher for subtype B. Among those who died during the study period, there were no differences between subtypes in the mean time from HIV or AIDS diagnosis to death. CONCLUSIONS Our results suggest that B and non-B HIV-1 subtypes found in Cuba do not differ in transmissibility and in clinical disease progression.

Vinte e dois cordeiros machos não castrados, Dorper x Santa Inês, com aproximadamente 90 dias de idade e peso vivo médio inicial de 27,0±4,4kg, foram alimentados com uma dieta com elevada proporção de concentrado com 20% de pelete proteico-mineral (Grano Entero(r)), 5% de feno de capim coast-cross e 75% de milho, na forma de milho grão inteiro (MGI), milho grão moído (MGM) ou milho grão úmido (MGU), para avaliação de desempenho no confinamento por um período de 14 dias de adaptação às dietas e às instalações e de 65 dias de confinamento. Em seguida, os animais foram abatidos com peso vivo médio final (PVF) de 47,97±5,13kg e o conteúdo gástrico foi avaliado para quantificação de protozoários, e foi realizada avaliação papilar. O delineamento experimental foi o de blocos casualizados. Não houve diferença entre os tratamentos (P&gt;0,05) quanto ao ganho de peso médio diário, eficiência alimentar, ingestão diária de matéria seca, características da carcaça e da carne. Os animais tratados com MGI tiveram maior conteúdo gástrico, menor pH ruminal, maior AP (% da superfície de absorção) e maior área papilar em comparação com os outros tratamentos. Os animais tratados com MGI tiveram melhores resultados para o peso final, mas para os demais parametros estudados não foi observada diferença.

Twenty-two males not neutered, Dorper x St. Agnes, with approximately 90 days of age and average live weight of 27.0±4.4kg were fed with a diet wich contained high concentrate with 20% protein pellet-mineral (Grano Entero (r)), 5% grass hay coast-cross and 75% corn in the form of whole kernel corn (MGI), ground corn grain (MGM) or high moisture corn (MGU) for performance evaluation in confinement for a period of 14 days of adaptation to the diets and facilities and 65 days of confinement. Then the animals were slaughtered at average final weight (PVF) of 47.97±5.13kg and gastric content was evaluated for quantification of protozoa, and a papillary review was conducted. The experimental design was in randomized blocks. There was no difference between treatments (P&gt;0.05) for average daily weight gain, feed efficiency, daily dry matter intake, carcass characteristics and meat. MGI-treated animals had higher gastric contents, the lower ruminal pH greater AP (% of surface absorption) and the larger papillary area was compared with other treatments. Animals treated with MGI had better results for the final weight gain, but for the other parameters studied, no difference was observed.

Introduction: the emergence of resistant virus antiretroviral human immunodeficiency type 1 (HIV-1) is a major cause of treatment failure. Objective: to analyze the mutations associated with antiretroviral resistance and resistance levels in a group of patients with failure criteria to antiretroviral therapy (HAART). Methods: Plasma samples from 25 individuals with failure criteria to HAART were collected out of 157 HIV-1 positive patients attending the Outpatient Infectious Diseases at Hermanos Ameijeiras Hospital during 2012. The viral subtype and resistance mutations were determined; and the time between the beginning of the last therapy and detection of resistant viruses was estimated time. Results: 52 % of patients had only received HAART regimen. Mutations associated with resistance in 84 % of patients were detected. 64 % had to antiretroviral treatment strategy employed as first high resistance in this country. The average time between the beginning of the last therapy and the detection of resistant viruses was 2.3 years. 16 % of patients had susceptible virus. The probability of non-adherence to HAART could be the cause of therapeutic failure in this group. Conclusions: high levels of resistance to first-line HAART used in Cuba and the emergence of resistant variants after starting treatment were evident. These results emphasize the need for monitoring resistance as part of comprehensive care for people living with HIV / AIDS.

Introducción: la emergencia de virus de inmunodeficiencia humana tipo 1 (VIH-1) resistentes a antirretrovirales constituye una de las principales causas de fallo terapéutico. Objetivo: analizar las mutaciones asociadas a resistencia a los antirretrovirales y los niveles de resistencia en un grupo de pacientes con criterios de fallo a la terapia antirretroviral de gran actividad (TARGA) durante el año 2012. Métodos: se colectaron muestras de plasma de 25 individuos con criterios de fallo a la TARGA, de los 157 pacientes positivos al VIH-1 que asistieron a la Consulta Externa de Infectología del Hospital "Hermanos Ameijeiras" durante el año 2012. Se determinó el subtipo viral y las mutaciones asociadas a resistencia y se estimó el tiempo transcurrido entre el inicio de la última terapia y la detección de virus resistente. Resultados: 52 % de los pacientes solamente había recibido un régimen de TARGA. Se detectaron mutaciones asociadas a resistencia en 84 % de los pacientes. El 64 % presentó alta resistencia a los antirretrovirales empleados como primera estrategia terapéutica en el país. El tiempo promedio entre el inicio de la última terapia y la detección de virus resistente fue de 2,3 años. El 16 % de los pacientes presentó virus susceptibles, en este grupo la probabilidad de no adherencia a la TARGA pudo ser la causa del fallo terapéutico. Conclusiones: se evidenciaron altos niveles de resistencia a la primera línea de TARGA empleada en Cuba y la aparición de variantes resistentes después de iniciar el tratamiento. Estos resultados enfatizan la necesidad del monitoreo de la resistencia como parte de la atención integral a las personas que viven con VIH/Sida.

Introduction: the use of antiretroviral therapy has facilitated the slow and partial recovery of the immune system, allowing to reduce opportunistic complications, to increase survival and to improve quality of life in patients infected with human immunodeficiency virus type 1. Objective: to determine rapid evolving viral variants with resistance to antiretroviral drugs in HIV-1 positive patients. Methods: two HIV-1 positive patients were studied. They were appointed by the letters A and B, respectively, and antiretroviral drug resistance were determined at two different times: Moment of diagnosis and 2012. Results were related to clinical variables. Results: at the time of diagnosis Patient A had subtype BG virus with low levels of resistance to zidovudine and stavudine. Patient B had subtype B virus with low levels of resistance to zidovudine. In 2012, the patient A showed FRC18-cpx viral variant with high levels of resistance to lamivudine, emtricitabine, and nevirapine. Patient B remained infected with subtype B virus, but resistant to the reverse transcriptase inhibitors. Conclusions: these results show the dynamic and rapidly evolving variants of HIV-1 infected patients.

Introducción: el empleo de la terapia antirretroviral ha facilitado la recuperación lenta y parcial del sistema inmune, lo que permite reducir las complicaciones oportunistas, incrementar la supervivencia y mejorar la calidad de vida en pacientes infectados por el virus de inmunodeficiencia humana tipo 1. Objetivo: determinar las variantes virales de evolución rápida a la resistencia a drogas antirretrovirales en pacientes positivos a VIH-1. Métodos: se estudiaron 2 pacientes positivos a VIH-1; se nombraron con las letras A y B, respectivamente, y se les determinó la resistencia a drogas antirretrovirales en 2 tiempos diferentes: momento del diagnóstico y 2012. Los resultados se relacionaron con variables clínicas. Resultados: el paciente A, en el momento del diagnóstico, presentó un virus subtipo BG con niveles bajos de resistencia a zidovudina y estavudina y el B, virus subtipo B, con bajos niveles de resistencia a zidovudina. En el año 2012, el paciente A mostró una variante viral FRC18_cpx con altos niveles de resistencia a lamivudina, emtricitabina y nevirapina. El paciente B se mantuvo infectado con un virus subtipo B, pero resistente a los inhibidores de la transcriptasa inversa. Conclusiones: estos resultados muestran la dinámica y rápida evolución de las variantes de VIH-1 en pacientes infectados.

FUNDAMENTOS: As dermatofitoses apresentam alta prevalência na população em geral e, principalmente, em pacientes com insuficiência renal crônica, necessitando tratamento com antifúngicos tópicos e/ou sistêmicos, cuja eficácia precisa ser avaliada. Estudos in vitro para avaliar a ação de antifúngicos são raros, especialmente, em fungos filamentosos. OBJETIVO: Avaliar o perfil de suscetibilidade de diferentes espécies de dermatófitos, isolados de pacientes com insuficiência renal crônica, em relação a nove antifúngicos disponíveis comercialmente para o tratamento de dermatofitoses. MÉTODO: Analisaram-se 26 isolados de dermatófitos de pacientes com insuficiência renal crônica em relação a nove antifúngicos (cetoconazol, ciclopirox olamina, fluconazol, griseofulvina, itraconazol, miconazol, piroctona olamina, terbinafina e tioconazol) pelo método de microdiluição em caldo proposto pelo Clinical and Laboratory Standards Institute (CLSI), com modificações para dermatófitos. RESULTADOS: Entre os antifúngicos testados, a terbinafina e o tioconazol obtiveram os melhores resultados de sensibilidade e o fluconazol apresentou baixa atividade, especialmente para as amostras da espécie M. gypseum. O ciclopirox olamina, apesar de menos eficaz que a terbinafina, também mostrou resultados satisfatórios. CONCLUSÕES: De modo geral, o perfil de sensibilidade dos antimicóticos testados seguiu o padrão de resultados mostrados por estudos anteriores, ratificando a necessidade de conhecimento da espécie causadora de dermatofitose, devido à variação do perfil de suscetibilidade entre as espécies. Além disso, nossos resultados demonstram a importância da realização de ensaios de sensibilidade in vitro, pois alguns isolados da mesma espécie apresentaram diferente perfil de sensibilidade

BACKGROUND: The prevalence of dermatophytosis in the general population is high, particularly in patients with chronic renal failure. Treatment requires the use of topical and/or systemic antifungal drugs. The efficacy of antifungal agents for the treatment of dermatophytosis has yet to be evaluated. Studies evaluating the in vitro activity of antifungal agents are rare, particularly in filamentous fungi. OBJECTIVE: To evaluate the susceptibility profile of different species of dermatophytes isolated from patients with chronic renal failure to nine antifungal drugs available on the market for the treatment of dermatophytosis. METHODS: Twenty-six isolates of dermatophytes obtained from patients with chronic renal failure were analyzed with respect to their susceptibility to nine antifungal agents (ketoconazole, ciclopirox olamine, fluconazole, griseofulvin, itraconazole, miconazole, piroctone olamine, terbinafine and tioconazole), using the broth microdilution method proposed by the Clinical and Laboratory Standards Institute (CLSI) and adapted for dermatophytes. RESULTS: Of the antifungal agents tested, the best results in terms of sensitivity were found with terbinafine and tioconazole, while the antifungal activity of fluconazole was found to be weak, particularly against strains of M. gypseum. Ciclopirox olamine, although less effective than terbinafine, also yielded satisfactory results. CONCLUSIONS: In general, the sensitivity profile of the antifungal agents tested in this study was similar to results obtained in previous studies, confirming the need to determine which species is causing the dermatophytosis given that antifungal susceptibility varies from one species to another. Furthermore, the present findings show the importance of conducting in vitro sensitivity tests, since the sensitivity profile may differ among isolates of the same species

By the classic biological assays it has been possible to determine the use of HIV-1 strains co-receptor, which have been classified in R5, X4 or R5/X4, characteristic related to the NIS or IS phenotype and to the clinical course. By bio-information methods the amino acid changes in the region of V3 loop of the env using the co-receptor. In present paper are showed the results of a characterization study of eleven strains from HIV-1 infected subjects, five seropositive and six with a fast progression to AIDS. Authors compared the results of phenotype study conducted by two classic assays, use of co-receptors and ability to induce syncytia in MT2 and three bio-information methods, rule 11/25, point matrices in specific locations (PSSM) and the geno2pheno program. The five strains from asymptomatic seropositive patients coincided according all methods used as R5/NIS. Five of the six strains from fast progression patients were classified as R5/X4 and IS by biological assays; whereas two were classified as R5/X4 by Geno 2 Pheno, one by PSSM and all were pure X4 by the rule 11/25. The assays used in the study allowed us to characterize the isolated strains and to relate the phenotype to the infection course, thus, we considered that using biological assays or bio-information methods it is possible to conduct characterization studies, its usefulness depends on the pursued objectives.

Mediante ensayos biológicos clásicos se ha podido determinar el uso del correceptor por las cepas de VIH-1, las cuales se han clasificado en R5, X4 o R5/X4, características que guardan relación con el fenotipo NIS o IS y con la evolución clínica. Por métodos bioinformáticos se han relacionado cambios aminoacídicos en la región del lazo V3 del env con el uso del correceptor. En este trabajo se presentan los resultados del estudio de caracterización de once cepas provenientes de individuos infectados con VIH-1, cinco de ellos seropositivos asintomáticos y seis progresores rápidos al SIDA. Se compararon los resultados del estudio fenotípico realizado por dos ensayos biológicos clásicos, uso de correceptores y capacidad de inducir sincicios en MT2 y tres métodos bioinformáticos, regla 11/25, matrices de puntos en posiciones específicas (PSSM) y el programa geno2pheno. Las cinco cepas de seropositivos asintomáticos coincidieron por todos los métodos como R5/NIS. Cinco de las seis cepas de progresores rápidos se clasificaron R5/X4 e IS por los ensayos biológicos; mientras dos clasificaron R5/X4 por Geno 2 Pheno, una por PSSM y todas fueron X4 puras por la regla 11/25. Los ensayos utilizados en el estudio permitieron caracterizar las cepas aisladas y relacionar el fenotipo con la evolución de la infección, por lo que valoramos que por ensayos biológicos o métodos bioinformáticas se pueden hacer estudios de caracterización, su utilidad está en dependencia del objetivo que se persiga.

INTRODUCTION: HIV-1 proviral DNA amplification is the preferential method for HIV diagnosis infection in infants and it has been used in Cuba since 1992. AMPLICOR HIV-1 DNA kit is an in vitro qualitative assay for the detection of HIV-1 proviral DNA in the whole blood. OBJECTIVE: this paper showed the results of the use of this kit for the first time in Cuba for the perinatal diagnosis of HIV-1 infection. METHODS: three hundred forty six whole blood samples from children of HIV seropositive women were analyzed by the AMPLICOR HIV-1 DNA kit in the period 2005-2007. RESULTS: among the tested samples, six were positive, and 340 negative. CONCLUSIONS: the assay was reproducible under the Cuban conditions and the achieved results made the diagnosis and follow up of children of HIV-1 seropositive mothers possible.

INTRODUCCIÓN: la amplificación del ADN proviral del VIH-1, constituye un método preferencial para el diagnóstico perinatal, empleado en Cuba desde 1992. El estuche AMPLICOR HIV-1 DNA es un ensayo cualitativo in vitro para la detección del ADN proviral de VIH-1 en sangre total. OBJETIVO: en el presente trabajo se reportan los resultados del empleo de este estuche por primera vez en Cuba para el diagnóstico perinatal de VIH-1. MÉTODOS: entre 2005 y 2007 se trabajaron mediante el estuche AMPLICOR HIV-1 DNA, 346 muestras de sangre total de niños nacidos de madres seropositivas al VIH-1. RESULTADOS: del total de muestras trabajadas, 6 resultaron positivas y 340 fueron negativas. CONCLUSIONES: el estuche fue reproducible en las condiciones cubanas y los resultados obtenidos permitieron realizar el diagnóstico y seguimiento de niños nacidos de madres seropositivas.